This is an Established Investigator award for Dr. Polly Newcomb to dedicate 30% effort to training and research in colorectal cancer survivorship. She is an experienced cancer prevention investigator with a long and successful record of NIH-funding. The population of cancer survivors is rapidly growing because of screening and treatment successes;today more than 11 million U.S. individuals have a history of cancer. Colorectal cancer is the second leading cause of cancer death among men and women combined in the United States. Therefore, identifying approaches to improve survival in colorectal cancer patients is a high priority for patients, clinicians, and caregivers. Colon cancer is a complex disease caused by the joint action of multiple factors both environmental and genetic;longevity after diagnosis too must reflect these joint effects. The goal of this K05 award is to identify modifiable and genetic factors, which will improve quality of life and extend survival after treatment for colorectal cancer in men and women. Cancer survivorship is a challenging area of prevention research with unique methods for analyses and controlling bias, making it a particularly important area for the training and development of junior investigators. With the support provided by this award, Dr. Newcomb will dedicate 15% effort to mentoring new cancer control researchers and provide the foundation for key investigations in colorectal cancer survivorship. Utilizing the Colon Cancer Family Registries (C-CFR), for which Dr. Newcomb is the Seattle PI, the proposed research will focus on lifestyle factors, such as physical activity and nutrition that colorectal cancer patients can alter to enhance longevity after diagnosis. In these studies, trainees and junior faculty will also take into account genetics, pathological characteristics, molecular markers, and treatment to assess predictors of recurrence and longevity, providing insights into the biology and care for colorectal cancer patients. This award will be a valuable mechanism to better understand the factors that can enhance survival, and in doing so, develop skilled researchers in cancer control. PUBLIC HEALTH RELEVANCE: This study proposes to evaluate modifiable and genetic factors associated with survival after a diagnosis of colorectal cancer and to train early investigators in this important but complex area of cancer research. The genetic analyses will help scientists examine biological mechanisms associated with cancer survivorship. Also, findings from this study will inform clinicians about lifestyle factors, such as physical activity, that may influence outcomes in colorectal cancer patients, thereby potentially providing a means to increase survival.